Status Update on Seasonal Flu Vaccine

Posted by:
Commissioner John Auerbach, Department of Public Health

This year the residents of Massachusetts and the nation faced the unusual occurrence of two simultaneous types of influenza - both seasonal and H1N1.  This increases the risk of illness for all Americans.  Fortunately, we have very effective tools to prevent both influenzas in the form of safe and reliable vaccines.  Unfortunately, neither the seasonal nor the H1N1 vaccines are as widely available as we would like. 

Certain delays in developing the H1N1 vaccine were anticipated, since it was a novel virus.   What wasn’t fully understood was how the dual goal of producing two types of flu vaccines would also affect the availability of the seasonal flu vaccine.  The same pharmaceutical companies are producing both vaccines.  And while they have done an admirable job, the added production and distribution pressures have resulted in delays in filling the orders of seasonal flu vaccine in our state and throughout the country.  

Complicating things further is the fact that the demand for seasonal flu vaccine this year is unprecedented.  This is a result in part of the good work that has been done by local, state and federal public health officials in educating the public about the benefits of vaccine.  The original plan of the federal government was to complete the production and distribution of the seasonal flu vaccine at the earliest possible date – several months before the seasonal flu begins to appear later in the year.  Federal guidance encouraged widespread seasonal flu vaccination efforts as early as possible so as not to compete with the later efforts regarding H1N1 vaccination.

Unlike H1N1 vaccine, most of the seasonal flu vaccine in Massachusetts and other states is ordered and paid for by the private sector. Hospitals, pharmacy chains, private group practices, employers and others order large quantities of vaccine directly from the pharmaceutical companies.  The specifics of the quantities ordered and the arrangements regarding price and distribution are not overseen by or shared with government agencies.  This leads to a situation where private entities – such as pharmacies and supermarkets – may have seasonal flu vaccine earlier and in larger quantities than local public health agencies and others who receive their allocations from the state health department.

The Massachusetts Department of Public Health typically orders about 30% of the seasonal flu vaccine in our state.  We distribute our flu vaccine to local health departments, community health centers, elder health programs and other community-based programs that serve some of the most vulnerable residents of the Commonwealth.  On any given year, the amount we purchase exceeds demand, and we end up with unused vaccine.  However, because of the particular concerns this year we increased our order by 10%, to 885,000 doses.
 
As of the third week of October we have received and distributed 631,530 doses of seasonal flu vaccine or about 71% of our total order of 885,000 doses. We have been informed by the manufacturers that we can expect additional shipments over the course of the next 4-6 weeks with the balance of our vaccine likely arriving by the end of November.  We have heard reports that the supply situation for private-purchased vaccine is similar.  

The combination of the unprecedented demand for seasonal flu vaccine and the delays in  shipments have meant that numerous local flu clinics have had to be cancelled or postponed and certain clinical practices have run short.  Fortunately, we do not expect to see the arrival of seasonal flu until later in the year, as the largest number of seasonal flu cases usually occur in January and February.

Given the unpredictability of the vaccine production and distribution process this year, we are reluctant to make predictions but we anticipate that as supplies arrive during the next several weeks, there will be additional opportunities for vaccination.  We will do our best to alert local health departments and other community health providers as the situation changes.

Comments

[Jim]

The most important single thing I learn by reading this blog: don't bother to ask a question here, it won't be answered. But maybe that's because all the questions have one thing in common: their askers haven't read the whole post, which uses many words to say (and this is the answer to everyone's questions) "We don't know where there's any vaccine or when there'll be any more."

[Dan K]

Where can I get these flu shots.

Dan

[Suzette]

It is the most ridiculous thing I have seen in a while. I am pregnant (high risk category I am told) with a child under 1 year and I am unable to find anyone with access to the seasonal flu vaccine. I received the H1N1 but the good old regular seasonal flu vaccine everyone as exhausted their supply and don’t anticipate getting anymore. What the heck is going on?

[Nancy]

All you hear from the government is to get your flu shot. Could you please tell me where I can get my patients their shots. I pre ordered my influenze 10 months ago only to find that my order will not be met. It is a sad day when primary care physicians can not immunize their patients. It appears that the regular flu was greatly ignored. Not only do we not have our regular flu we also do not have our H1N1. We are telling our elderly patients to find local clinics, which are severly limited, so they can stand in line along with 500 other local residents to find out that only 300 doses would be available. We are asking them to pay out of pocket at local pharmacies, when, if received by their physicians office their insurance would cover it. How is this allowed to happen?

[cheryl]

I am sick of all this talk about getting the vaccine. Instead of everyone saying the same thing - get vaccinated, maybe they can work on making it available. I am pregnant with twins (therefore in a high risk category) and I can't find either flu shot and am told by my OB's office that they don't know when they will get a shipment. How am I suppose to get vaccinated if there are none? You say pregnant women should get it - then at least make it available to them!
I am terrified everytime I step outside and go to the grocery store or doctors/hospital for my prenatal care that I will catch something.

[Suzanne]

Sam--I am in the same boat in Arlington, except it's my providers that will not have the vaccine (I'm pregnant). It's my understanding that Arlington has yet to schedule any h1n1 clinics, it was their seasonal flu clinic that was cancelled. The Board of Health told me that if I can't get it through my doctors (OB or PCP) I would have to wait until it's available to the general public.

I have heard of other people switching pediatricians just to get the vaccine. I am considering switching PCPs to try to find one who will carry the vaccine.

[Sam]

I have two children under the age of three. The pediatrician in Lexington does have the H1N1 vaccine, but only for their patients. Unfortunatley, the pediatrician to which we belong has never received the H1N1 vaccine and and does not know when or if they ever will. They are located in Arlington. My pediatrician's office redirected me to our town H1N1 flu clinic, only that was cancelled. Also, this clinic is for ages 4 and up. So, what are our options? I am deeply concerned for my children's health and where should I look next for the vaccine?

[Jay]

My son is 8 months old and we are debating whether to have him vaccinated with the current H1N1 vaccine that we've heard has trace amounts of mercury or wait until the individual doses that are intended specifically for kids under three are available. Any advice would be helpful.

[Duvet Cover Sets]

I guess with all the swine flu talk, we kind of ignored the regular flu. but good thing that one has been predictable and it did not get us by surprise like the H1N1